After his high school graduation, Ray Miller, 43, hit his head in a motorcycle accident. Miller suffered traumatic brain injury, which impaired his ability to speak.

For him, life would never be the same. Because of the accident, Miller also has memory loss and is disabled. Because of the pain, the smile on his face disappears when he sits down, stands up or walks.

Miller attends therapy sessions at the Sir Alexander Ewing Speech and Hearing Clinic at the college, which provides prevention, evaluation and treatment services for communication disorders involving speech and hearing problems.

Miller is one of the clients who relies on “augmentative and alternative communication.” This includes therapy sessions and technological devices that allow people with disabilities and speech disorders to speak.

Miller’s clinician is Kathy Delahanty, a graduate student at the college.

“In general, Ray is a happy person,” she said. “I know he sometimes gets frustrated because he had the injury at a very young age, at the time he was just starting his life.” Graduate students in the speech pathology and audiology department are assigned as clinicians for two or more clients per semester, and they receive credit for assessment and therapy. Students work with clients for one-hour sessions twice a week.

They also develop treatment plans based on clients’ needs. The services include solving problems with articulation or speech sound, stuttering, voice, language, accents and hearing. The clinic also offers assistive technology for voice.

Since the accident, Miller has communicated with people through a speech-generating device produced by DynaVox Systems. There are different types of DynaVox devices for different needs. Miller’s DynaVox is considered “high tech” and is made up of a small portable computer with a black and white screen and a keyboard.

When he types words on his keyboard, a male voice is generated. The price of these speech-generating devices ranges from $3,500 to $8,000. They are usually paid for by the clients’ insurance companies.

While Miller’s speech loss was a result of an accident, others have no voice as a result of an injury at birth, cerebral palsy or a stroke. Cerebral palsy is the loss of voluntary muscular control and coordination. There is no cure for the disorder, and the treatment consists of speech, physical and occupational therapy.

Anna Orak, 72, was born with cerebral palsy and has been coming to the clinic for more than 15 years. When Lindsay Pendergast, her clinician and graduate student at the college, asks Orak to show her angry face to the other group members, she can only keep it for a few seconds. Then she moves her head to the side and starts laughing loudly.

“[Orak] is known as the most fun and popular client,” Pendergast said.

Because Orak doesn’t know how to read, her device has folders with pictures. All she needs to do to say what she wants is touch the screen.

Liz Begley, clinical assistant professor in the department of speech language pathology and audiology and a supervisor at the clinic, said the clinic’s goal is to teach clients how to program devices, so they can speak fluently.

“These speech-generating devices allow these individuals to have equal access to communication,” Begley said. “Having no voice doesn’t mean they aren’t bright.”

During the individual therapy sessions, clients work on specific needs such as remembering specific labels for words or using the speech-generating device to make phone calls.

These clinic sessions also create a challenge for undergraduate and graduate students who experiment with therapy techniques and help clients find their direction, Begley said.

“Students’ responsibility to the clients creates such a great training ground and experience for the students,” Begley said. Most clinicians will work in hospitals, schools and large practices, Begley said.

Sarah Bognar, another graduate clinician, said, in the beginning, she was anxious and nervous when she started to work with a client.

Bognar said one of her clients, 43-year-old Jim Severino, makes her job easier because he always has something to say. She said she talks about many topics with Severino, who has cerebral palsy.

“It’s amazing that without even using his device, he quickly finds a way to explain what he wants,” Bognar said.

Hearing assessments or speech language and hearing evaluations are available to students, employees, faculty, staff and administration without charge, said Christine Cecconi, clinical associate professor and director at the clinic.

Speech pathology and audiology students also work at the college’s Voice and Swallowing Clinic, located adjacent to the Cayuga Ear, Nose, Throat and Allergy Associates in Ithaca. The clinic uses a model where graduate students observe medical procedures used to diagnose disorders.

Severino recently visited the clinic for a coevaluation of his swallowing. Because the roof of his mouth is deep, Severino has problems while chewing and swallowing the food.

The Sir Alexander Ewing Speech and Hearing Clinic also offers a variety of community programs including the Oral Rehabilitation Home at Kendal at Ithaca, a retirement and rehabilitation home, and the Center for Life Skills at Longview. The Oral Rehabilitation Program, for example, is for elderly people to improve their hearing. At Longview, the clinic also offers interdisciplinary programs with occupational therapy and physical therapy. Cecconi said because of the services the clinics provide, the department is equipped to help people with communication disorders.

“We can really make a huge impact on these people’s lives,” Cecconi said.